Different Types Of Orthoses Research Articles

Effectiveness of Orthotic Treatment on Clinical Outcomes of the Patients with Adolescent Idiopathic Scoliosis Under Different Wearing Compliance Levels

Background: Wearing spinal orthosis for 16 to 23 hours a day during the teenage years could be challenging and stressful for patients with adolescent idiopathic scoliosis (AIS). The investigation of clinical outcomes under various orthosis-wearing compliances can provide helpful insight into orthotic treatment dosage. This systematic review aims to investigate actual orthosis-wearing compliance and evaluate the effectiveness of orthotic treatment in controlling scoliotic curvature and preventing surgery for patients with AIS under various levels of orthosis-wearing compliance. Methods: A literature search of 7 electronic databases, namely PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL Complete, Web of Science, and Embase, was conducted on May 19, 2023. Participant characteristics, orthotic treatment protocols, compliance information, outcome measures, and key findings were extracted. The Newcastle-Ottawa Scales were used to evaluate the quality of included cohort and case-control studies. Results: This study systematically reviewed 17 of 1,799 identified studies, including 1,981 subjects. The actual compliance was inconsistent and ranged from 7.0 to 18.8 hours daily. The proportion of compliant subjects in each study varied from 16.0% to 78.6% due to the heterogeneity of calculation period, measurement methods, and orthosis prescription time. Thirteen studies were investigated to determine the effectiveness of orthotic treatment in controlling curve deformity under different compliance groups, and 2 studies compared the compliance under different treatment outcomes. The rate of curve progression, defined as surpassing the measurement error threshold of 5° or 6° after orthotic treatment, varied from 1.8% to 91.7% across the studies. Ten studies defined the treatment failure, surgery, or surgery indication as Cobb angle progressing to a certain degree (e.g., 40°, 45°, or 50°) and reported failure/surgery/surgery indication rates ranging from 0.0% to 91.7% among different compliance level groups. Conclusion: This review found that the actual compliance with orthotic treatment was generally lower than the prescribed wearing time and exhibited wide variation among different studies. The electronic compliance monitors show promise in regular orthotic treatment practice. More importantly, the group with higher and consistent compliance has significantly less curve progression and lower surgery or failure rate than the group with lower and inconsistent compliance. Further studies are proposed to investigate the minimal orthosis-wearing compliance in patients with AIS treated with different types of orthoses. Level of Evidence: Level III, Systematic Review. See Instructions for Authors for a complete description of levels of evidence.

Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment

Systematic review. Spinal orthoses are frequently used to non-operatively treat osteoporotic vertebral fractures (OVF), despite the available evidence is rare. Previously systematic reviews were carried out, presenting controversial recommendations. The present study aimed to systematic review the recent and current literature on available evidence for the use of orthoses in OVF. A systematic review was conducted using PubMed, Medline, EMBASE and CENTRAL databases. Identified articles including previous systematic reviews were screened and selected by three authors. The results of retrieved articles were presented in a narrative form, quality assessment was performed by two authors using scores according to the study type. Thirteen studies (n = 5 randomized controlled trials, n = 3 non- randomized controlled trials and n = 5 prospective studies without control group) and eight systematic reviews were analyzed. Studies without comparison group reported improvements in pain, function and quality of life during the follow-up. Studies comparing different types of orthoses favor non-rigid orthoses. In comparison to patients not wearing an orthosis three studies were unable to detect beneficial effects and two studies reported about a significant improvement using an orthosis. In the obtained quality assessment, three studies yielded good to excellent results. Previous reviews detected the low evidence for spinal orthoses but recommended them. Based on the study quality and the affection of included studies in previous systematic reviews a general recommendation for the use of a spinal orthosis when treating OVF is not possible. Currently, no superiority for spinal orthoses in OVF treatment was found.

Solution of the contact task of the elbow orthosis prototype

Over the past two decades, upper limb exoskeletons used for service delivery and rehabilitation have attracted attention from the biomedical and engineering sectors. Technology is becoming one of the key solutions for physically weak or disabled people. Mechanical devices were developed to improve the performance and strength of the user. Devices that help the patient during postoperative or post-traumatic rehabilitation after joint damage of various types are orthoses. There are different types of orthoses, such as mechanical, active with EMG functions, exoskeletons, and others. In this work, an overview of various types of orthoses is given, problems of fixing orthoses elements are considered. In the review of the literature related to these studies, the advantages and disadvantages of bolted connections are given. Two contact problems of the orthosis were also considered and the stress-strain state of the bolted joint of the structural elements of the elbow orthosis prototype under study was determined using the FEMAP with NASTRAN software package. Based on the necessary operating conditions, a prototype model of the orthosis was presented.

Knee Orthosis for Anterior Cruciate Ligament Injuries - Kinematics and Comfortability Study

Knee orthosis is commonly used in supporting the knee movement and protecting the anterior cruciate ligament (ACL) injuries from worsening. In clinical practices, there are many types of ready-made orthoses that available in the market. However, different types of orthoses may provide different performances for patient’s knee joint. Therefore, this paper attempt to investigate the performance of knee orthoses for ACL-injured knee. Two groups took part in the study; (Group 1) six ACL-injured, (Group 2) four healthy participants, where two types of knee orthoses were adopted; (Brace 1) hinge brace, (Brace 2) sleeve brace with bilateral hinges. The knee joint motions were calculated using kinematics data while comfortability was conducted through surveys. From the findings, Brace 1 produced normal range of motion (ROM) for internal rotation at 5.47° while Brace 2 fall outside of the normal range at 2.165°. Meanwhile, the external rotation for Brace 1 (-13.25°) was lower than Brace 2 (-33.25°). Furthermore, the comfortability analysis suggested that Brace 1 (60%) was more effective than Brace 2 (40%). To conclude, Brace 1 portrayed optimal performance than Brace 2 during dynamic balance activities with reduction in ROM to prevent excessive knee rotation.

The Effect of Spinal Orthoses on Immobilizing the Cervical Spine: A Systematic Review of Research Methodologies

ABSTRACT Introduction The purpose of this article is to review the literature on the effect of immobilization of the cervical spine using orthotic devices. The review focused on the methodologies of the studies to see if this might be a contributing factor to the lack of available clinical guidelines on spinal immobilization using orthoses. Methods This review was conducted using PRISMA guidelines (PLoS Med. 2009;6:e1000097). The search was conducted in August 2019 within all major databases using relevant phrases. No date restrictions were applied, but the search was restricted to full manuscripts published in English. These searches were then supplemented by tracking all key references from the appropriate articles identified. Articles were selected according to a priori–defined criteria. Initially, data were extracted regarding publication details, orthosis name and group, spinal level studied, and whether cervical range of motion was measured. Results A total of 52 articles fulfilled the inclusion criteria. This article discusses the methodology of the included studies. Conclusions There is a clear paucity of well-designed research on immobilization of the cervical spine using orthotic devices. Comparing the results of studies using different types of orthoses is difficult due to the type and age of the participants involved (healthy, pathological, cadaver) and the different techniques of measurement used. This lack of standardization prevents meta-analyses from being performed and may be a contributing factor to the lack of available clinical guidelines. An agreed structured methodology is required to enable meta-analyses and determine clinical guidelines for the prescription of spinal orthoses for cervical spine pathology.

Rehabilitation following surgery for flexor tendon injuries of the hand.

Rehabilitation following surgery for flexor tendon injuries of the hand.

Different Types of Orthoses in the Management of Genu-recurvatum, What are the Best Choices?

Different Types of Orthoses in the Management of Genu-recurvatum, What are the Best Choices?

Interventions for idiopathic toe walking.

Interventions for idiopathic toe walking.

A comparison of the hallux valgus angle, range of motion, and patient satisfaction after use of dynamic and static orthoses

BackgroundConservative treatment is recommended for mild and moderate hallux valgus. The treatment may include two different types of orthoses: a dynamic orthosis and a static orthosis. The aim of this study was to compare the hallux valgus angle, hallux valgus range of motion, and patient satisfaction after the use of a dynamic and a static orthosis for the treatment of hallux valgus. MethodsTwenty-four participants contributed to this cross-over study. Participants were randomly allocated to orthotic treatments at the start. The hallux valgus angle and range of motion were measured using a goniometer. Pain, signs and symptoms, function in activities of daily living (ADL), function in sport and recreation, and foot and ankle-related quality of life (QOL) were measured using the Foot and Ankle Outcome Score (FAOS) questionnaire. The participants then switched to using the other orthosis. A one-way repeated measure ANOVA was conducted to compare the measured variables in subjects at 4 conditions before and after of using each orthosis. ResultsThere was a significant difference in the hallux valgus angle (p=0.001). The Bonferroni test indicated that both static and dynamic orthoses significantly decrease the angle of hallux valgus, respectively before static, after static (mean difference=−2.67, p=0.001) and before dynamic, after dynamic conditions (mean difference=−2.13, p=0.02). There was also a significant difference in subjects range of motion by using a dynamic orthosis in before dynamic, after dynamic conditions (mean difference=9.77, p=0.01). There was no significant difference in total FAOS score within the conditions (p=0.067). ConclusionThe use of both static and dynamic orthoses for 1 month can reduce the hallux valgus angle up to 2–3°. To achieve better results, it is suggested to wear orthoses for longer time. The dynamic orthosis also increases the passive range of motion of the first metatarsophalangeal joint and it seems to be effective during walking.

Restrictions in the Ankle Sagittal- and Frontal-Plane Range of Movement during Simulated Walking with Different Types of Orthoses

Different types of orthoses are available to clinicians for non-surgical treatment of acute ankle sprains. The goal of this study was to scientifically compare the movement restrictions in the sagittal and frontal plane during simulated walking between one adaptable semi-rigid brace (OrthoTri-PhaseTM), four non-adaptable semi-rigid braces (OrthoStandardTM, MalleoLocTM, MalleoSprintTM, VACOankleTM), and one rigid cast. Predefined time sequences of rotational moments and axial loading during gait were applied via an ankle joint simulator, with the pneumatic pressure inside the orthoses kept constant to ensure the same condition for different trials and orthoses. The peak ranges of motion (RoMs) in the frontal and sagittal plane during gait were analyzed for statistically significant differences using single-factorial ANOVA with post-hoc Bonferroni analysis. Significant differences in peak plantar-/dorsiflexion and in-/eversion RoM during gait were found between different types of orthoses. In the sagittal plane, the rigid cast most significantly restricted overall RoM followed by the Ortho Tri-PhaseTM in Phase 1 and the Ortho StandardTM. The peak restriction in-/eversion RoM of the VACOankleTM came closest to the rigid cast, with a shift towards inversion. The VACOankleTM allowed for significantly larger dorsiflexion movement compared to all other orthoses. The present results may help clinicians in the decision-making process of finding the optimal orthosis for individual patients.

O-2-17. Influence of different types of orthoses on muscle synergy control during gait in stroke patients with hemiparesis

The purpose of this study was to verify the influence of lower limb orthoses on muscle synergy control during gait in stroke patients with hemiparesis. In four subjects with acute stroke, surface EMG signals from eight muscles of the paretic lower limb were measured during gait in two conditions (ankle foot orthosis; AFO or knee ankle foot orthosis; KAFO). The number of modules, muscle weightings and activation timing profile of each module were analyzed using non-negative matrix factorization. In two subjects (Fugl Meyer Assessment; FMA > 20) who walked with mild assistance, three modules were identified during gait with KAFO, whereas two modules were identified with AFO. The third module was composed of triceps surae activities in the late stance phase of the gait cycle. In two subjects (FMA

The necessity of using high quality orthoses in rehabilitation medicine

In rehabilitation medicine there is increasing need of using high quality orthoses that can provide either good stability of the joint or good correction of the postural defect. The advantages of using orthoses that are in the same time hypoallergenic, lightweight, flexible, resistant and durable over time should be considered when prescribing them in clinical practice. This study presents different types of orthoses and the necessity of proper selection of materials when choosing the best ones. We included 34 patients diagnosed with different musculoskeletal conditions (thoracic and thoraco-lumbar scoliosis, genu valgum deviation and rheumatoid arthritis) that required the use of special orthoses (thoraco-lumbar braces, knee or hand orthoses). Patients were asked to complete a questionnaire regarding the quality of the orthoses that they have been used. The following characteristics of an orthosis should be considered when choosing the right one: easily wearable, comfortable, offering good stability of a joint, high quality, lightweight, hypoallergenic and resistant.

Necessity of Immobilizing the Metacarpophalangeal Joint in Carpometacarpal Osteoarthritis: Short-term Effect.

Conservative treatment for carpometacarpal (CMC) joint osteoarthritis (OA) may include orthotic fabrication to decrease pain. Different types of orthoses have been used as conservative interventions to improve symptoms, but there are no guidelines specifying if inclusion of the thumb metacarpophalangeal (MCP) in an orthosis is required in the treatment of thumb CMC joint OA. The main objective of this study is to determine the effectiveness of 2 different thumb CMC joint orthotic designs on pain reduction and improved hand function: one design immobilizes both the MCP joint and the CMC joint and the other design immobilizes only the CMC joint. A total of 66 patients were included in the study. One group of 33 patients received a short thumb orthosis with the MCP joint excluded, and the other group of 33 patients received a short thumb orthosis with the MCP joint included. Outcomes measures included the visual analog scale for pain and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH; Spanish version) for function. In both patient groups, the orthoses contributed to decreased pain levels and improved functional abilities ( F1.0 = 315.467 and F1.0 = 72.419; both, P < .001). There was no significant difference between the 2 groups regarding pain or improvement in daily activities ( F1.0 = 0.553 and F1.0 = 2.539; both, P > .05). There are benefits of either thumb orthotic design on pain reduction and functional improvement even after 1 week of using the orthoses as the sole conservative treatment.

Rehabilitation following surgery for flexor tendon injuries of the hand

Rehabilitation following surgery for flexor tendon injuries of the hand

National profile of foot orthotic provision in the United Kingdom, part 1: practitioners and scope of practice

BackgroundFoot orthoses have been advocated in the management of a wide range of clinical foot and lower limb problems and are within the scope of podiatry, orthotic and physiotherapy practice. Previous reports into the provision of orthoses have consistently identified significant issues with services and devices, but data were never specific to foot orthoses. The aim of this first of a series of papers was to report the first ever national multi professional profile of foot orthosis provision in the United Kingdom.MethodsQuantitative and qualitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases. The professions were targeted through electronic and printed materials. Data were captured over a 10 month period in 2016.ResultsA total of 499 responses were included in analysis, including 357 podiatrists, 93 orthotists and 49 physiotherapists. The results reveal wide ranging practices across podiatrists, orthotists and physiotherapists, provision of orthoses through different health care departments (uni and multidisciplinary), for different health conditions (acute and chronic), and involving different types of orthoses (prefabricated and customised).ConclusionFoot orthoses in the United Kingdom are provided in areas of well recognised health and rehabilitation priorities. A wide range of orthotic devices and practices are employed and different professions provide foot orthoses in different ways.

Interventions for idiopathic toe walking

Interventions for idiopathic toe walking

Prospective study of spinal orthoses in women.

There are not many clinical trials investigating the efficiency and compliance of using spinal orthoses in the management of osteoporosis. The purpose of this study was to investigate the effect of long-term use and the compliance of spinal orthoses in postmenopausal women with vertebral fractures. Clinical trial of spinal orthoses in postmenopausal women. Women were separated into groups wearing different types of orthoses (Spinomed, Osteomed, Spinomed active, and Spine-X). Isometric maximum strength of trunk muscles (F/Wabdominals-extensors) was calculated and back pain was assessed in all women. In addition, women completed a compliance questionnaire about the use of the orthoses. Spinomed decreased pain (p = 0.001) and increased trunk muscle strength (F/Wabdominals, p = 0.005 and F/Wextensors, p = 0.003, respectively). The compliance of wearing an orthosis for 6 months was 66%. The results suggest that orthoses could be an effective intervention for back pain and muscle strengthening in osteoporotic women. In women with established osteoporosis, wearing Spinomed orthosis for at least 2 h/day for 6 months decreased back pain significantly and increased personal isometric trunk muscle strength. All spinal orthoses could be valuable instruments to help all requested rehabilitation programs like spine muscles' strengthening and postural correct behavior, but only when used properly.

Orthotic variations in the management of infantile tibia vara and the results of treatment

Infantile tibia vara is an acquired form of tibial deformity associated with tibial varus and internal torsion. Several methods have been described for orthotics treatment. The purpose of this study was to determine the effectiveness of orthotics treatment in infantile tibia vara. Controlled trial. The aim of this study was to compare the effect of different types of orthoses and correction methods on decreasing the curve in children with severe genu varum. Three different types of knee-ankle-foot orthoses were applied to 35 lower extremities of 22 pediatric participants who were 19-38 months of age. The same orthotic design principles were used to correct the femur, while different designs were applied to correct the tibia. The orthoses used on 20 participants were evaluated for differences among them and their effects on the treatment process. In addition, methods used in the treatment, problems encountered, production of different types of orthoses, convenience of application of the orthoses, and degree of patients satisfaction are discussed in this article. The mean duration of treatment of the participants until completion of treatment was 25.3 ± 9.7 weeks with a minimum of 9 weeks and a maximum of 41 weeks. No statistically significant correlation was found between the duration of orthotic use in patients with a successful outcome and percentile height and percentile weight. When the duration of treatment using the different types of orthoses was analyzed, significant differences were found between Type 1 and Type 2, and Type 1 and Type 3 orthoses (p < 0.05), while no difference was observed between Type 2 and Type 3 orthoses (p > 0.05). We found that bracing is an effective form of treatment for infantile tibia vara up to 38 months of age. We conclude that full-time use of knee-ankle-foot orthoses exerting corrective forces from five points along the full length of the limb was effective.

The Effects of Three Different Types of Orthoses on the Range of Motion of the Lumbar Spine During 15 Activities of Daily Living

Prospective cohort study. To quantify which 3 common lumbar orthoses of varying rigidity restrict both full, active range of motion (ROM) and functional ROM required for activities of daily living (ADL). Spinal orthoses are implemented to restrict lumbar motion. Despite widespread prevalence of lumbar bracing, the efficacy of these appliances for immobilizing the spine has not been definitively established. The full, active ROM of 10 asymptomatic individuals was quantified using an electrogoniometer that registered maximum rotation in all planes. Subjects subsequently completed 15 simulated ADLs during which time their functional ROM was measured; performed without a brace and while wearing a corset, semirigid lumbosacral orthosis (LSO), and rigid custom-molded LSO. For flexion/extension, the mean percentage decreases (with SDs) in full, active ROM that were recorded with corset, semirigid, and a custom orthosis were 24.1 ± 7.9%, 46.8 ± 7.1%, and 64.7 ± 8%, respectively (P < 0.001 relative to no brace). In the coronal plane, motion was restricted by 33.9 ± 8.8%, 51.9 ± 9.4%, and 49.1 ± 11.8%, respectively (P < 0.001). Finally, rotation was limited by 39.6 ± 8.8%, 59.2 ± 10.2%, and 70.6 ± 5.4%, respectively (P < 0.001). There were no significant discrepancies between the ROM recorded in the semirigid and custom LSOs for the ADLs. Likewise, functional ROM associated with corset and semirigid LSOs were only different for 2 ADLs whereas significant disparities between values with corset and custom LSOs were observed for 4 simulations. The full, active ROM allowed by lumbar braces evaluated was greater than employed during ADLs in absence of any brace. The motion decrease beyond actual restriction of the braces suggests they will act primarily as proprioceptive guides to regulate movement.

Insoles, External Joint Supports, and Multi-Intervention Training Programs Reduce Sports Injuries

Question: What are the effects of interventions designed to prevent sports injuries? Data sources: MEDLINE, PubMed, the Cochrane Central Register of Controlled Trials, SPORTDiscus, CINAHL, PEDro (to 2005), personal files, and reference lists of retrieved articles and relevant reviews. Selection criteria: Randomized or quasirandomized controlled studies were selected if they evaluated the effects of any preventive intervention on sports injuries, were fully published in peer-reviewed journals before January 1, 2006, reported injury rates, and described explicitly the intervention protocol and outcome measures. Thirty-two studies (24,931 participants) met the selection criteria. The quality of study methods was assessed with use of an 11-point scoring criteria (score range, 0 = low to 11 = high). Quality scores ranged from 1 to 8 points (mean 3.8 points). Main outcome measure: Injury. Main results: Insoles: 5 studies (6 comparisons, n = 2446) compared the use of custom-made or prefabricated insoles with the use of no insoles to reduce lower extremity injuries. Five of the 6 comparisons showed a benefit for insoles (odds ratio [OR] range, 0.10 to 0.70). One study (n = 874) compared different types of orthoses and found no difference among groups. External joint supports: Seven studies (n = 10,300) evaluated the use of external joint supports. Three of 4 studies showed that ankle orthoses or ankle stabilizers reduced injury (OR range, 0.16 to 0.60). One study of outside-the-boot braces showed no statistical difference between groups. In 1 study of prophylactic knee braces and 2 studies of wrist protectors, the use of supports reduced injury (OR range, 0.12 to 0.43). Training programs; balance board: Two of 4 studies (n = 1799) showed a benefit for balance-board training programs (OR range, 0.16 to 0.24), whereas 2 studies showed a nonsignificant increase in injuries with balance-board training. Training programs; multi-interventions with balance board: Two studies (n = 400) showed that multi-interventions that included the use of balance-board training reduced injuries (OR range, 0.20 to 0.29). Training programs; other multi-interventions: Four studies (n = 2409) showed that multi-intervention programs that included exercise and rehabilitation (without balance-board training) reduced injuries (OR range, 0.18 to 0.53; 1 study did not report data for calculating an OR). Stretching and warm-up programs: Three studies (n = 3052) showed that stretching and warm-up exercises did not reduce injuries. Mouth guards: One of 2 studies (n = 947) showed that custom-made mouth guards reduced head and/ or facial injuries (relative risk 0.56, 95% confidence interval 0.32 to 0.97). Modified shoes: Three studies (n = 1402) showed that modified basketball shoes did not prevent injury. Videos: Of 2 studies (n = 1034), 1 showed that an instructional ski video reduced sports injuries. In the other study, a video-based awareness program did not reduce sports injuries. Conclusion: The use of insoles, external joint supports, and multi-intervention training programs can reduce sports injuries. Stretching and warm-up programs and modified shoes did not reduce injuries. The evidence was mixed for balance-board training programs, mouth guards, and videos.